<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191230146
Report Date: 08/27/2025
Date Signed: 08/27/2025 04:34:56 PM

Document Has Been Signed on 08/27/2025 04:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:L.A.VALLEY COLLEGE CAMPUS CHILD DEVE.CTR.FACILITY NUMBER:
191230146
ADMINISTRATOR/
DIRECTOR:		JENNIFER GUEVARAFACILITY TYPE:
840
ADDRESS:5800 FULTON AVENUETELEPHONE:
(818) 947-2931
CITY:VALLEY GLENSTATE: CAZIP CODE:
91401
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 0DATE:
08/27/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:39 PM
MET WITH:JENNIFER GUEVARATIME VISIT/
INSPECTION COMPLETED:
04:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 08/27/2025, Licensing Program Analyst (LPA) Suzette Ornelas conducted an unannounced Case Management – Incident inspection related to a self-reported Unusual Incident Report (UIR) submitted on 08/21/2025. Upon arrival, LPA met with Director, JENNIFER GUEVARA, and explained the purpose of the visit. LPA observed 0 children in care due to school currently not being in session.

According to the UIR, on 07/31/2025, 4 out of 6 staff observed S2 to be acting differently than normal when returning to the classroom (where children were present) from their lunch break. Staff described S2's behavior as happier than usual, giggling, speaking loudly, unable to understand what they were saying, asking children math questions and giving them the wrong answers. 2 of the 6 staff stated that they smelled alcohol on S2's breath. S6 removed S2 from the classroom immediately upon suspicion and did not return to the classroom that day.

On 8/26/2025, the UIR (LIC624) was submitted in writing to the department via email.

During today’s inspection, LPA conducted interviews and obtained documents. Per Director, she was not present the day the incident took place.LPA obtained copies of statements written by staff who were present to observe the incident. LPA obtained a copy of a Criminal Record Exemption Needed for S2 that the facility obtained on 8/27/2025. As of today LPA confirmed that, S2 is Eligible/Cleared on Guardian.

Due to the Unusual Incident not being reported to the El Segundo Regional Office by telephone or fax within the Department's next working day and during its normal business hours and in writing within 7 days, 1 Type B deficiency is being cited in accordance to Title 22 of the California Code of Regulations for Reporting Requirements (101212). Please refer to 809-D for cited deficiencies.

NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Suzette Ornelas
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: L.A.VALLEY COLLEGE CAMPUS CHILD DEVE.CTR.
FACILITY NUMBER: 191230146
VISIT DATE: 08/27/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
1 Type B deficiency is being cited in relation to facility not reporting the incident in the timely manner required in accordance to Title 22 of the California Code of Regulations: Reporting Requirements (101212). Please refer to 809-D for cited deficiencies.

1 Type A deficiency is being cited in relation to S2's behavior in accordance to Health and Safety Code Chapter 03.4 California Child Day Care Act Article 04: 1596.885 Denial, suspension or revocation of license, registration, or special permits; grounds. Please refer to 809-D for cited deficiencies.

Licensee was advised upon receive of this report, the report must be posted along with the notice of site visit for 30 days for parents to view. Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC 9224 Acknowledgement of Receipt of Licensing Reports. If the Licensee fails to comply $100.00 civil penalty shall be assessed for each family enrolled and in attendance. Exit interview conducted with the licensee and a copy of this report was provided along with the appeal rights.

At this time, no further investigation is needed.
An exit interview was conducted with Director, JENNIFER GUEVARA, A copy of this report and Notice of Site Visit were provided and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Suzette Ornelas
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 08/27/2025 04:34 PM - It Cannot Be Edited


Created By: Suzette Ornelas On 08/27/2025 at 01:46 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: L.A.VALLEY COLLEGE CAMPUS CHILD DEVE.CTR.
FACILITY NUMBER: 191230146

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2025
Section Cited
HSC
1596.885(c)

1
2
3
4
5
6
7
1596.885 Denial, suspension or revocation of license, registration, or special permits; grounds (c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. This requiremnt is not met as evidence by:
1
2
3
4
5
6
7
Director will have staff meeting with individual and provide documetation of memorandum. Once Director obtains further guidance from supervisor a letter of repremand will be given to S2.
8
9
10
11
12
13
14
Based on interviews and documentation, S2 did not comply with the section cited above in being under the influence in the classroom while children were present, which poses/posed an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Type B
09/26/2025
Section Cited
CCR101212(d)

1
2
3
4
5
6
7
101212 Reporting Requirements (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. This requiremnt is not met as evidence by:
1
2
3
4
5
6
7
Director has called the incident in and submitted the required LIC624 unusual incident report form.
DIrector will be holding new school year staff meeting and go over reporting requirements to ensure all staff follow Title 22 reporting reuirements moving forward.
8
9
10
11
12
13
14
Based on interviews and documentation, facility did not comply with the section cited above in not reporting an unusual incident within the required time frame which poses/posed a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Suzette Ornelas
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2025


LIC809 (FAS) - (06/04)
Page: 4 of 4